Carers' Perceptions of Seclusion and Restraints in Mental Healthcare: An Integrative Literature Review.

It included only 10 peer-reviewed English studies, so it may not represent carers in other languages or settings. The included studies were published between 1993 and 2019, so some may not reflect current practice. Study quality ranged from high to low, with concerns about sampling, measurement, nonresponse and integration of methods. It combined carers who had witnessed seclusion or restraint with carers who had not, which may weaken the link to lived experience. It analysed seclusion and restraints together, so it cannot separate the effects or preferences of chemical, physical, mechanical and seclusion practices. The review reports perceptions and suggestions, not tested outcomes, so it cannot show that empathy, carer involvement or environmental changes reduce restrictive practices.

The first author received funding from King Abdulaziz University to publish the article as open access. The authors declared no conflicts of interest.

Do not conclude that involving carers or empathy training reduces seclusion and restraint. This review reports carers' perceptions and recommendations, not tested outcomes. Do not assume all carers oppose every restrictive practice; some found chemical or physical restraint more acceptable than seclusion or mechanical restraint when safety could not be achieved another way.